Call to Congress to reject mail for Tricare comes at critical time as pharmacy, PBM war heats up

By Antoinette Alexander

WHAT IT MEANS AND WHY IT'S IMPORTANT — The call to Congress to reject budget proposals that would increase co-pays for prescription medications at community pharmacies for Tricare patients is important as the war between the pharmacy and pharmacy benefit manager lobbies heats up.

(THE NEWS: NACDS, NCPA urge Congress to reject proposal that discourages Tricare patients' use of community pharmacies. For the full story, click here.)

As the articles states, the call to action by the National Association of Chain Drug Stores and the National Community Pharmacists Association aims to strike down a provision in the governments FY 2013 budget that would increase co-pays for prescription medications at community pharmacies for Tricare patients, but lower co-pays for prescriptions filled via mail order.

Such a policy would not only impose higher-out-of-pocket costs on Tricare beneficiaries and reduce access to care, but it is especially important to win the hearts and minds in Washington right now, as the clock ticks on the FTC's decision over ESI-Medco.

Meanwhile, one big payer has weighed on the side of patient access when the state of Nebraska announced that it would leave ESI to stick with Walgreens. Reports indicated that Nebraska officials will switch health insurance carriers, as of July 1, from Blue Cross/Blue Shield to United Healthcare. A key reason for the switch: State employees want access to Walgreens pharmacies. More than half of the 15,000 state employees and 30,000 dependents presently have their prescriptions filled at a Walgreens pharmacy, according to reports. Plus, the move is expected to save $8 million per year.